Aetna negotiated rates in Montana
How Aetna's Montana rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Montana at a glance
What the data shows
Aetna ranks 1st of 4 payers in Montana with a rate index of 123 (100 = the Montana market median), across 54 procedure codes.
Aetna has the highest median for 68% of codes in Montana.
Aetna's Montana rates sit 36% above its own national level, the 5th highest of its 51 states.
Largest premium over the Montana market: CPT 72197 (Mri pelvis w/o & w/dye) at 179% of market; largest discount: CPT 99490 (Chrnc care mgmt staff 1st 20) at 56%.
How the four payers compare in Montana
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Aetna | 123 | 1 | 68% | 80 | |
| UnitedHealthcare | 114 | 2 | 69% | 323 | |
| Cigna | 100 | 3 | 13% | 367 | |
| Blue Cross Blue Shield | 100 | 3 | 4% | 409 |
Where Aetna pays most and least against the Montana market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 72197 Mri pelvis w/o & w/dye | $979 | $546 | +79% | 29 |
| 77049 Mri breast c-+ w/cad bi | $994 | $556 | +79% | 29 |
| 74174 Cta abd&plvs w/contrast | $1,094 | $616 | +78% | 29 |
| 72158 Mri lumbar spine w/o & w/dye | $920 | $518 | +78% | 29 |
| 70551 Mri brain stem w/o dye | $561 | $318 | +76% | 29 |
| 72125 Ct neck spine w/o dye | $369 | $210 | +76% | 29 |
| 71260 Ct thorax dx c+ | $474 | $270 | +76% | 29 |
| 76641 Ultrasound breast complete | $284 | $162 | +75% | 29 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99490 Chrnc care mgmt staff 1st 20 | $44 | $78 | -44% | 22 |
| 99215 Office o/p est hi 40 min | $143 | $226 | -36% | 71 |
| 99205 Office o/p new hi 60 min | $193 | $284 | -32% | 73 |
| 99457 Rpm tx mgmt 1st 20 min | $32 | $47 | -32% | 15 |
| 99213 Office o/p est low 20 min | $71 | $103 | -31% | 77 |
| 99454 Rem mntr physiol param 16-30 | $52 | $75 | -30% | 15 |
| 99214 Office o/p est mod 30 min | $107 | $152 | -30% | 77 |
| 93306 Tte w/doppler complete | $232 | $310 | -25% | 23 |
Where Aetna pays above and below its national level
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 306 | 211 | |
| Idaho | 152 | 491 | |
| Washington | 142 | 708 | |
| Mississippi | 138 | 608 | |
| Montana | 136 | 80 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Indiana | 80 | 698 | |
| South Dakota | 82 | 147 | |
| Florida | 82 | 758 | |
| Minnesota | 84 | 774 | |
| North Dakota | 85 | 211 |
Frequently asked questions
Does Aetna pay more or less than the other payers in Montana?
Aetna ranks 1st of 4 in Montana with an index of 123. It is highest on 68% of codes.
Are Aetna's Montana rates above or below its national level?
About 36% above.
Which procedure does Aetna pay most above market in Montana?
CPT 72197 (Mri pelvis w/o & w/dye), at 179% of the Montana median.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your Aetna contract at market in Montana?
Compare your negotiated rates for these codes with Montana medians for each payer.